GLIM Criteria for the Diagnosis of Malnutrition: A Consensus Report From the Global Clinical Nutrition Community

Abstract

Abstract Background This initiative aims to build a global consensus around core diagnostic criteria for malnutrition in adults in clinical settings. Methods The Global Leadership Initiative on Malnutrition (GLIM) was convened by several of the major global clinical nutrition societies. Empirical consensus was reached through a series of face‐to‐face meetings, telephone conferences, and e‐mail communications. Results A 2‐step approach for the malnutrition diagnosis was selected, that is, first screening to identify at risk status by the use of any validated screening tool, and second, assessment for diagnosis and grading the severity of malnutrition. The malnutrition criteria for consideration were retrieved from existing approaches for screening and assessment. Potential criteria were subjected to a ballot among GLIM participants that selected 3 phenotypic criteria (non‐volitional weight loss, low body mass index, and reduced muscle mass) and 2 etiologic criteria (reduced food intake or assimilation, and inflammation or disease burden). To diagnose malnutrition at least 1 phenotypic criterion and 1 etiologic criterion should be present. Phenotypic metrics for grading severity are proposed. It is recommended that the etiologic criteria be used to guide intervention and anticipated outcomes. The recommended approach supports classification of malnutrition into four etiology‐related diagnosis categories. Conclusions A consensus scheme for diagnosing malnutrition in adults in clinical settings on a global scale is proposed. Next steps are to secure endorsements from leading nutrition professional societies, to identify overlaps with syndromes like cachexia and sarcopenia, and to promote dissemination, validation studies, and feedback. The construct should be re‐considered every 3–5 years.

Keywords

Affiliated Institutions

• Brigham and Women's Hospital US
• Research Institute for Aging CA
• American Society for Parenteral and Enteral Nutrition US
• Alfred Health AU
• Rabin Medical Center IL
• University of Illinois Chicago US
• Monash University AU
• Siriraj Hospital TH
• Amsterdam University Medical Centers NL
• Pontificia Universidad Católica de Chile CL
• Universidade de São Paulo BR
• University of Pennsylvania US
• Hospital Clínico Universitario de Caracas VE
• Peking Union Medical College Hospital CN
• Stellenbosch University ZA
• Hospital General de México MX
• Tel Aviv University IL
• Karolinska University Hospital SE
• University of Waterloo CA
• Saint Louis University Hospital US
• Fujita Health University Hospital JP
• Uppsala University Hospital SE
• Sapienza University of Rome IT
• Universidade Católica de Pelotas BR
• The Ohio State University US
• Ministry of Science and Technology Thailand TH
• Central University of Venezuela VE
• Ospedale di Cattinara IT
• University of Trieste IT
• Vrije Universiteit Amsterdam NL
• St. Luke's Medical Center PH
• HAN University of Applied Sciences NL
• Radboud University Medical Center NL
• University of Warwick GB
• Universidade Federal de Minas Gerais BR
• Khon Kaen University TH
• Erasmus Hospital BE
• University of Vermont US
• Radboud University Nijmegen NL
• Chinese Academy of Medical Sciences & Peking Union Medical College CN
• University of Alberta CA

Related Publications